Reconecta Starting Questionnaire Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone numberHow long have you been dealing with this pain or problem?Less than 3 monthsBetween 3 and 12 monthsMore than one yearWhat have you tried so far?PhysiotherapyMedical consultations/ testsMedicationOtherHow does this problem affect your daily life at the moment?What is your main goal for the future if this situation improved? process, dealing the Would you be willing to actively take part in a process, not just receive a treatment?YesNoI’m not sureHow would you prefer to take part in the Reconecta process?Reconecta – individual, in personReconecta – group, in personReconecta – individual, onlineI’m not sure yetComplete the initial questionnaire
